肝脏介入术后并发肝脓肿的治疗分析

目的探讨肝脏介入术后肝脓肿发生的原因及治疗。方法回顾性分析20例患者行介入治疗术后并发肝脓肿的原因。CT确诊脓肿后均抗炎治疗,所有患者行经皮穿刺脓肿引流,抗生素盐水脓腔冲洗。结果 20例肝脓肿患者中,5例(25%)有肝脏部分切除史,其中4例(20%)行胆肠吻合术,糖尿病患者7例(35%),8例(40%)患者有胆道疾病行PTBD术史。所有患者行抗生素抗炎及经皮穿刺肝脓肿引流术治疗后临床症状均明显缓解。结论介入治疗后并发肝脓肿的原因复杂,对高危患者应积极预防,经皮穿刺肝脓肿引流是肝脓肿治疗的有效手段。

Objective To investigate the causes and the management of liver abscess that developed after hepatic intervention. Methods Retrospectively analyzed 20 patients who had liver abscess after hepatic interventional therapy All the cases were confirmed by CT and given anti- inflammatory treatment, all of the patients were underwent percutaneous hepatic abscess drainage, antibiotics and saline were used to wash the abscess. Results 5/20 cases （25%） had a history of partial liver resection, 4/20 cases （20%） with the history of biliaryenteric anastomosis. 8/20 cases （40%） had biliary disease and 7 cases （35%） with diabetes mellitus. After anti-inflammation therapy and percutaneous hepatic abscess drainage treatment, all patients were significantly remission. Conclusion The reason of liver abscess after intervention is complex. Active prevention should be paid to high-risk patients. Percutaneous hepatic abscess drainage is an effective means of treatment.